decisionhealth Newsletters, Part B News - 2019 Issue 10 (October)
Bypass chronic care management barriers that suppress revenue, care plans
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Article Overview
This article covers chronic care management (CCM) as a Medicare Part B service, why practices face obstacles in implementing it, and the broader policy and patient-cost issues affecting uptake. It is aimed at physicians, billers, coders, care managers, and practice leaders who need a general understanding of CCM program challenges, coverage context, and the types of coding guidance discussed for monthly care management reporting.
Why This Topic Matters
CCM can improve coordination for patients with multiple chronic conditions, but practices may underuse it because of documentation burden, patient cost-sharing concerns, and coding complexity. Understanding the article helps organizations evaluate whether CCM fits their workflow and how the associated billing topics are organized in current guidance.
Article Sections
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CCM adoption barriers and policy context
Introduces chronic care management services, the patient population they affect, and the broad operational and policy barriers that limit adoption. It also places the topic in the context of Medicare and Medicare Advantage coverage.
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Seeking solutions
Discusses general efforts to reduce financial and administrative obstacles to CCM use. The section focuses on stakeholder concerns and proposed policy changes at a high level.
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Successfully code CCM visits
Reviews the article’s billing-oriented guidance for CCM encounters, including the kinds of reporting considerations and code-group relationships that coders and billers should be aware of.
What You Will Learn
- The general purpose and scope of chronic care management services
- Common operational barriers that affect CCM adoption
- How CCM is positioned within Medicare coverage discussions
- The types of billing and documentation considerations associated with CCM encounters
- Which categories of related services may create claim conflicts
Who Should Read This
- Medical coders
- Billers
- Practice managers
- Physicians
- Nurse care managers
- Revenue cycle staff
- Compliance teams
Codes Discussed
Code Ranges Discussed
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